Helping people avoid nursing homes

June 22, 2007|By GENE STOWE Tribune Correspondent

A change in approach to care for the elderly in the past year has helped more than 200 Michiana people who had been placed in nursing facilities move back home, increasing their comfort while saving money.

Â?It definitely is true the in-home services are much more cost-effective than nursing facility placements,Â? says Pat Gilbert, care management director at REAL Services Inc. Â?A lot of times weÂ?ve noticed itÂ?s about one-third of the cost.

Â?The state has made some effort to get people out of nursing homes and back into the home with in-home services. Medicaid pays for either nursing facility placement or in-home services. They have done it for quite a few years.Â?

Early last year, Medicaid introduced a Priority Diversion Aged and Disabled Medicaid Waiver that could pay for in-home services rather than nursing facilities for those who qualify.

Â?We kind of ran with it and changed our way of looking at it,Â? Gilbert says. Â?Instead of just making sure they meet that level of care, we offer them the option of coming home.

Â?We changed our approach in March of 2006. We have brought many home because of the way weÂ?ve changed things and made an effort to look at people in the nursing home as a possibility of coming home.Â?

Real Services, the Area Agency on Aging for Elkhart, Kosciusko, LaPorte, Marshall and St. Joseph counties, has used the waiver to help 215 people avoid or leave placement in nursing facilities since last July.

Â?Area 2/REAL Services has brought more people home in this state than any other area in the state Â? even more than some states have done,Â? Gilbert says. The process is cumbersome, Gilbert says.

Â?They donÂ?t make it easy to come home,Â? she says. Â?ItÂ?s hard for vendors to get reimbursed. They havenÂ?t made it an easy process to get the in-home services paid for by Medicaid.

Â?WeÂ?ve had people die in the process of getting services approved for them to come home.Â?

SheÂ?s concerned that the process could be even more delayed if state officials contract with an out-of-state business to handle the work. They are considering such a move, she says, and Area Agencies on Aging have written to ask that the state not make the change.

Â?ItÂ?ll take much longer to get the person out of the nursing facility and back into their own home,Â? Gilbert says.

REAL Services manages the cases, but certified private agencies provide the in-home services directly. Covered services include personal emergency response units, attendant care, home-delivered meals, home modifications and respite care. Â?We contract with home health agencies,Â? Gilbert says. Â?We do the case management part as far as determining eligibility, determining what services would best benefit them in the home, monitoring those services.Â?